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Found 12156 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:573674 (history)  Vaccinated:2013-09-04
Age:0.2  Onset:2014-10-02, Days after vaccination: 393
Gender:Female  Submitted:2015-01-09, Days after onset: 99
Location:Foreign  Entered:2015-01-13, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: 32 weeks gestation, Premature birth
Diagnostic Lab Data: Blood culture (02Oct2014): pneumococcal infection serotype 19A with pneumococcal meningitis; MRI scan (date unspecified): revealed devastating brain injury with extensive mieningo-enc (multi focal).
CDC Split Type: 2015003967
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG792930UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood culture positive, Meningitis pneumococcal, Nuclear magnetic resonance imaging abnormal, Pneumococcal infection, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This is a spontaneous report from a contactable healthcare professional via the Agency. A 15-month-old female patient received as immunisation three doses of PREVENAR 13; first dose (batch/lot G79293, expiry date Mar2015) on 04Sep2013 at the age of 2 months, second dose (batch/lot G33994, expiry Apr2015) on 19Nov2013 at age of 4 months and booster dose (batch/lot H46986, exp Nov2015) on 07Aug2014 at age of 13 months. Relevant medical history included premature birth at 32 weeks gestation. The patients concomitant medications were not reported. On 02Oct2014 the patient experienced a pneumococcal infection serotype 19A with pneumococcal meningitis which was reported as a vaccination failure. The specimen was taken from a blood culture on 02Oct2014. It was unknown if the patient was in a risk group. An MRI scan performed on an unspecified date revealed devastating brain injury. The patient died on an unknown date. It was unknown if an autopsy was performed. No follow-up possible. No further information expected.

VAERS ID:573706 (history)  Vaccinated:2014-05-09
Age:0.7  Onset:2014-11-21, Days after vaccination: 196
Gender:Female  Submitted:2015-01-09, Days after onset: 49
Location:Foreign  Entered:2015-01-13, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: 21-NOV-2014, Blood culture, pneumococcal infection, serotype 19F
CDC Split Type: 2015003985
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG343701UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bacteraemia, Blood culture positive, Death, Developmental delay, Hypermobility syndrome, Pneumococcal infection
SMQs:
Write-up: This is a spontaneous report from a contactable healthcare professional via the Agency. A 14 months old female patient of an unspecified ethnicity received her first single dose of PREVENAR 13 (lot G33225) on 16Nov2013 when she was 2 months old. The second single dose was received on 09May2014 from lot G34370 when she was 8 months old. Relevant medical history and concomitant medications were not reported. On 21Nov2014, the patient experienced pneumococcal infection, serotype 19F which involved hospitalization. The specimen was taken from the blood culture on 21Nov2014. The patient was reported to be 14 month old at the time of infection. It was also noted that the patient also suffered from bacteraemia, developmental delay and wrist hypermobility and transferred from a hospital. The onset dates of these conditions had not been specified. On an unknown date, the patient died as a result of the pneumococcal infection. The outcomes of the other events prior to the patient death were unknown at the time of this report. No follow-up attempts possible. No further information expected.

VAERS ID:561009 (history)  Vaccinated:2014-09-03
Age:0.5  Onset:2014-09-03, Days after vaccination: 0
Gender:Female  Submitted:2015-01-12, Days after onset: 131
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1501USA002681
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSE4T920UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH969AA0UNRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG776430UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0027850PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed vocational nurse (LVN) refers to a 6 month old female patient. Patient''s medical history included vaccination on 21-APR-2014 with the first dose of ROTATEQ (2 ml, orally, lot # J002785), first dose of DTAPHBIP (default manufacturer GlaxoSmithKline reported as "GSK") (0.5 ml, left right thigh, lot # UH969AA) and with first dose of PCV 13 (default manufacturer: Pfizer reported as "PFI") (0.5 ml, right thigh, lot # G77643), and on 02-JUL-2014 with second dose of ROTATEQ (2 ml, orally, lot # J004875), second dose of DTAPHBIP (GSK) (0.5 ml, left thigh, lot # 2EB97), second dose of HIB (AVP) (0.5 ml, right thigh, lot # UH969AA) and second dose of PCV 13 (0.5 ml, right thigh, lot # H17300). Patient had no history of chickenpox. On 03-SEP-2014, the patient was vaccinated with incorrectly stored dose of ROTATEQ (third dose, lot # J004875, 2 ml, orally). Concomitant therapies included third dose of DTAPHBIP, HIB and PCV 13. No adverse symptoms were reported. No product quality complaint (PQC) was involved. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:561013 (history)  Vaccinated:2014-10-30
Age:0.4  Onset:2014-10-30, Days after vaccination: 0
Gender:Male  Submitted:2015-01-12, Days after onset: 74
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1501USA002683
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS 0UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEUR 0UNRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0135890PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed vocational nurse (LVN) refers to a 4 month old male patient. Patient had no history of chickenpox. On 30-OCT-2014, the patient was vaccinated with first dose of ROTATEQ (dose: 2 ml, orally) (lot # J013589, expiration date: 06-JUN-2015) which was incorrectly stored. Concomitant therapies included DTAPHBIP (default manufacturer GlaxoSmithKline reported as "GSK"), HIB (default manufacturer: Sanofi reported as "AVP") and PCV 13 (default manufacturer: Pfizer reported as "PFI"). No adverse symptoms were reported. No product quality complaint (PQC) was involved. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:561014 (history)  Vaccinated:2011-12-13
Age:19.0  Onset:2011-12-30, Days after vaccination: 17
Gender:Male  Submitted:2015-01-12, Days after onset: 1109
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: Labs: 7/29/10: T3/T4/TSH wnl, Methylmalonic Acid 172, Homocysteine 7.8, Vit B12 801, Vit D 31. 6/28/12 CMP: wnl, CBC with diff: wnl. 7/17/13: vitD 25-hydroxy: 20.4L; 8/2/12 TSH 1.81. 8/22/13: PTH 13L, ESR 2, Vit B12 890, TSH/T4 wnl, CMP wnl, CRP <0.3, CK 412H, ANA neg, Aldolase 7.7H, Lactic Acid 19, Methylmalonic Acid 142, Pyruvic Acid 0.2. 11/14/13: CK 760H, CMP/CBC wnl, TSH 4.510H, T4 1.28, ANA neg, ESR 2, PTH 13L, Vit B12 959H, Lactic Acid 14.6, Aldolase 9.8H, Methylmalonic Acid 132. 2/6/14: Adenovirus Ab 1:16H. 4/18/14: GD1a Ab (IgM) <1:800, GD1a Ab (IgG) <1:100, GD1b Ab (IgG) <1:100, GD1b Ab (IgM) <1:800, GM-1 Ab (IgG/IgM) <1:800, MAG AB (IgM) neg, ASIALO-GM-1 AB (IgM) <1:1600, ASIALO-GM-1 AB (IgG) <1:100, CK 640H, LDH 189, protein ele
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ADEN_4_7: ADENOVIRUS TYPES 4 & 7, LIVE, ORAL (NO BRAND NAME)TEVA PHARMACEUTICALS3460018 UNUN
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501117P IN 
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB223CA1UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4078AA UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B071AA UNUN
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Adenovirus test positive, Aldolase increased, Amino acid level, Angiogram, Angiogram normal, Anti-ganglioside antibody negative, Antibody test negative, Antinuclear antibody negative, Arthralgia, Blood 25-hydroxycholecalciferol, Blood creatine phosphokinase increased, Blood homocysteine normal, Blood immunoglobulin G normal, Blood immunoglobulin M decreased, Blood lactate dehydrogenase normal, Blood lactic acid, Blood parathyroid hormone, Blood pyruvic acid, Blood thyroid stimulating hormone decreased, Bone scan abnormal, Burning sensation, Bursitis, C-reactive protein normal, Demyelinating polyneuropathy, Differential white blood cell count normal, Electromyogram abnormal, Electrophoresis protein normal, Femur fracture, Full blood count normal, Gait disturbance, Iliotibial band syndrome, Immunoelectrophoresis, Intervertebral disc protrusion, Limb discomfort, Metabolic function test normal, Muscle contractions involuntary, Muscular weakness, Myokymia, Nerve conduction studies abnormal, Nuclear magnetic resonance imaging spinal abnormal, Pain in extremity, Peripheral sensory neuropathy, Peripheral swelling, Red blood cell sedimentation rate normal, Scoliosis, Spinal muscular atrophy, Spondylolisthesis, Stress fracture, Thyroxine normal, Tri-iodothyronine normal, Ultrasound scan normal, Vitamin B12 increased, Vitamin D, Walking aid user, X-ray limb abnormal, X-ray of pelvis and hip normal
SMQs:, Rhabdomyolysis/myopathy (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Demyelination (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Osteoporosis/osteopenia (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: The patient (who is right hand dominant) was in his normal state of good health when he received Adenovirus, TWINRIX, FLUMIST, Tdap, PREVNAR 13 and MENACTRA vaccinations on 12/13/11. The patient reported to medical for the first time on 12/30/11 with complaints of a 2 day history of right knee pain. The pt. was diagnosed with iliotibial band friction syndrome and treated with NSAIDS, ice and stretching exercises. His knee was injected with Corticosteroids on 1/3/12 for continued symptoms. On 1/11/12 the pt. was seen for a 5d history of left knee pain. An x-ray revealed mild tissue swelling. On 1/12/12 the pt. received TWINRIX #2 and IPV vaccinations. The pt. was seen in medical again on 1/13/12, 1/20/12 and 1/30/12 and 2/6/12 for either right or left knee pain. He was diagnosed with bursitis and treated with ice and NSAIDS. The pt. received a Yellow Fever vaccination on 2/14/12. He was seen in medical on 2/22/12 for continued right knee pain with prolonged activity. A slightly antalgic gait was noted on examination. The pt. states that he was the last person to complete the 3 mile run. He knew that "something was wrong"--it seemed like his legs were getting heavier and heavier and that his calves were not working properly. When he was finished with a physical task (running, walking, hiking) his legs "felt like noodles". The pt. denied experiencing lack of bowel or bladder control. When the pt. went to training he felt that the physical activity was always a constant struggle and that "his feet were on fire". He also felt like because his calves were not doing any of the work and that his quads were being "overworked". Although the pt. continued to pass the physical requirements he was always in last place and continually falling behind. When the pt. reported to school, April 2012 he began to experience left hip pain and eventually bilateral thigh pain. He was diagnosed with bilateral femur stress fractures (per Bone Scan 5/7/12) and had to walk with crutches. According to the patient, the Orthopedic provider considered recommending the patient for a medical board but the patient refused. When he reported at Aug 2012, he could not complete the fitness test due to weakness in his lower legs. The patient had issues with marching--he could not maintain the cadence due to "walking with a limp". When the patient explained that he had had issues he was referred to medical and placed TMPQ at Jan 2013. The patient has not attended drills for 12 months while undergoing evaluation per his medical providers. The patient was seen by his PCM and 3 Neurologists. The consensus is that the patient has Distal Spinal Muscular Atrophy.

VAERS ID:561019 (history)  Vaccinated:2014-10-01
Age:0.2  Onset:2014-10-01, Days after vaccination: 0
Gender:Male  Submitted:2015-01-12, Days after onset: 103
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1501USA002685
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS 0UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEUR 0UNRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0135890PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed vocational nurse (LVN) refers to a 2 month old male patient. Patient had no history of chickenpox. On 01-OCT-2014, the patient was vaccinated with first dose of ROTATEQ (dose: 2 ml, orally) (lot #J013589, expiration date: 06-JUN-2015) which was incorrectly stored. Concomitant therapies included DTaPHBIP (default manufacturer GlaxoSmithKline reported as "GSK"), HIB (default manufacturer: Sanofi reported as "AVP") and PCV 13 (default manufacturer: Pfizer reported as "PFI"). No adverse symptoms were reported. No product quality complaint (PQC) was involved. This is one of several reports received from the same reporter. Additional information has been requested .

VAERS ID:561020 (history)  Vaccinated:2014-08-11
Age:0.4  Onset:2014-08-11, Days after vaccination: 0
Gender:Male  Submitted:2015-01-12, Days after onset: 154
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1501USA002684
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS 1UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEUR 1UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 1UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0113421PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed vocational nurse (LVN) refers to a 4 month old male patient. Patient''s medical history included vaccination on 11-JUN-2014 with the first dose of ROTATEQ (2 ml, orally, lot # J022342), first dose of DTAP HBIP (default manufacturer GlaxoSmithKline reported as "GSK") (0.5 ml, right thigh, lot #2G437), first dose of HIB (default manufacturer: Sanofi reported as "AVP") (0.5 ml, left thigh, lot # U1045AA) and with first dose of PCV 13 (default manufacturer: Pfizer reported as "PFI") (0.5 ml, left thigh, lot # H08094). Patient had no history of chickenpox. On 11-AUG-2014 the patient was vaccinated with second dose of ROTATEQ (dose: 2 ml, orally, lot # J011342) which was improperly stored. Concomitant therapies included DTAPHBIP, HIB and PCV13. On 30-OCT-2014, the patient experienced patient received third dose of ROTATEQ (dose: 2 ml. orally, lot # J013589, expiration date: 06-JUN-2015) which was improperly stored. Concomitant therapies included DTAP HBIP, HIB and PCV 13. No adverse symptoms were reported. No product complaint (PQC) was involved. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:561031 (history)  Vaccinated:2014-09-10
Age:0.2  Onset:2014-09-10, Days after vaccination: 0
Gender:Male  Submitted:2015-01-12, Days after onset: 124
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1501USA002687
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS 0UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEUR 0UNRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0048750PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed vocational nurse (LVN) refers to a 2 month old male patient. Patient had no history of chickenpox. On 10-SEP-2014, the patient was vaccinated with incorrectly stored dose of ROTATEQ (first dose, lot # J004875, expiration date: 17-OCT-2014, 2 ml, orally). Concomitant therapies included first doses of DTaPHBIP (default manufacturer GlaxoSmithKline reported as "GSK"), HIB (unspecified carrier) (default manufacturer: Sanofi reported as "AVP") and PCV13 (unspecified) (default manufacturer: Pfizer reported as "PFI"). On 11-NOV-2014, the patient was vaccinated with incorrectly stored dose of ROTATEQ (second dose, K001194, expiration date: 06-NOV-2015 2 ml, orally). Concomitant therapies included second doses of DTaPHBIP, HIB (unspecified carrier) and PCV13 (unspecified). No adverse symptoms were reported. No product quality complaint (PQC) was involved. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:561075 (history)  Vaccinated:2015-01-05
Age:1.0  Onset:2015-01-07, Days after vaccination: 2
Gender:Female  Submitted:2015-01-08, Days after onset: 1
Location:Georgia  Entered:2015-01-12, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.K0095060SYRLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH889603SYRRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0079510SYRLL
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Rash morbilliform
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Morbilliform rash developing 2 days after PREVNAR vaccine, with larger area of erythema surrounding vaccine injection site. No signs of secondary infection or severe allergic reaction.

VAERS ID:561107 (history)  Vaccinated:2015-01-09
Age:65.0  Onset:2015-01-09, Days after vaccination: 0
Gender:Female  Submitted:2015-01-12, Days after onset: 3
Location:Wisconsin  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: The most recent injection was the 23, the previous 2 injections were for the pneumo 13
Current Illness: No
Preexisting Conditions: Medical conditions: hyperlipidemia, HTN, GERD, obesity, depression, asthma, allergic rhinitis, acne rosacea, personal history of TIA, DM type II, DJD, venous insufficiency, healthcare maintenance, hypothyroid. Allergies: Bactrim, doxycycline, environmental, Keflex, minocycline, neosporin, Norvasc, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498492IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Injection site hard, red, painful, itching, warm to touch, 3" in diameter.

VAERS ID:561114 (history)  Vaccinated:2015-01-04
Age:75.0  Onset:2015-01-04, Days after vaccination: 0
Gender:Female  Submitted:2015-01-12, Days after onset: 8
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100 mg
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None...did not realize that possible penetration of the bursa occurred.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Drug administered at inappropriate site, Injected limb mobility decreased, Injection site injury, Injection site pain
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: SIRVA Shoulder Injury from Vaccine. Flu shot in right arm was administered high on the deltoid. Hurt a great deal. Followed a few hours later with intense pain and limited range of motion that interfered with daily activity. Continuing for 8 days, with lessening pain and gradual increased ROM. Took Advil and applied warm compresses on Day 2.

VAERS ID:561415 (history)  Vaccinated:2014-12-09
Age:1.3  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Well baby check
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4630AA3IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498463IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0029910PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug administered to patient of inappropriate age, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt was given Rotavirus out of range preferred pt is 15 months, pt broke out with rash on stomach.

VAERS ID:565042 (history)  Vaccinated:2015-01-07
Age:68.0  Onset:2015-01-10, Days after vaccination: 3
Gender:Female  Submitted:2015-01-12, Days after onset: 2
Location:New Hampshire  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Codeine, GI upset; Latex, rash
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498420IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Vaccination site pain, Vaccination site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Given PREVNAR 13 on 1/7/15. Developed redness, swelling, tenderness at vaccine site on 1/9-10. Worsening over time.

VAERS ID:565065 (history)  Vaccinated:2014-12-30
Age:78.0  Onset:2014-12-30, Days after vaccination: 0
Gender:Female  Submitted:2015-01-02, Days after onset: 3
Location:Florida  Entered:2015-01-12, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NEXIUM; Estrogen; PROLIA
Current Illness:
Preexisting Conditions: Difficulty with tetanus shot approx 10 yrs ago or more
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0UNRA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Muscle spasms, Nasopharyngitis, Pain in extremity, Peripheral swelling, Pyrexia, Sinusitis, Skin warm
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severely sore arm-hot-swollen-painful fever of 101.8, cramping in feet, severe headache which decreased proportionally as the fever reduced. This lasted until today. I am left with a head cold and sinus infection.

VAERS ID:565068 (history)  Vaccinated:2015-01-06
Age:1.0  Onset:2015-01-08, Days after vaccination: 2
Gender:Male  Submitted:2015-01-12, Days after onset: 4
Location:Massachusetts  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever~DTaP + IPV + Hib (Pentacel)~2~0.40~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.K0095060IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0148730SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ168823IMRL
Administered by: Private     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rash neck to lower back 1-9-15. Hives on leg 1-8-15.

VAERS ID:560930 (history)  Vaccinated:2015-01-10
Age:73.0  Onset:2015-01-10, Days after vaccination: 0
Gender:Female  Submitted:2015-01-11, Days after onset: 1
Location:Kansas  Entered:2015-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Knot, hard deposit in buttock~ ()~~0.00~Patient
Other Medications: Advair, albuterol nebulizer, Combivent, trihexylphenidyl, phenytoin, simvastatin, Zolpidem, fluphenazine, levothyroxine, divalproex ER, Restasis
Current Illness: No
Preexisting Conditions: Aneurysm/seizure disorder, COPD, hypothyroidism, Parkinsons
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ238630IMRA
Administered by: Other     Purchased by: Public
Symptoms: Dyskinesia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Extreme pain, tingling down to fingers, 2 fingers moved involuntarily.

VAERS ID:560939 (history)  Vaccinated:2014-11-10
Age:0.2  Onset:2014-11-10, Days after vaccination: 0
Gender:Male  Submitted:2015-01-11, Days after onset: 62
Location:Texas  Entered:2015-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Normal labs, brain MRI and EEG.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS43GM40IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUI062AE0IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ114840IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0079110PO 
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Electroencephalogram normal, Laboratory test normal, Nuclear magnetic resonance imaging brain normal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Recurrent afebrile seizures. Brain MRI/EEG normal. Doing well on Keppra.

VAERS ID:560876 (history)  Vaccinated:2014-11-19
Age:65.0  Onset:2014-11-19, Days after vaccination: 0
Gender:Female  Submitted:2015-01-10, Days after onset: 52
Location:Utah  Entered:2015-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolin N insulin, AmLODIPine, Cozaar, Simvastin, Wellbutrin.
Current Illness: No
Preexisting Conditions: Type 2 Diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH    
Administered by: Public     Purchased by: Other
Symptoms: Injection site swelling, Mobility decreased
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site swelled up the size of an egg. I could not move my arm for two days.

VAERS ID:560917 (history)  Vaccinated:2015-01-07
Age:71.0  Onset:2015-01-08, Days after vaccination: 1
Gender:Female  Submitted:2015-01-10, Days after onset: 2
Location:Massachusetts  Entered:2015-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH862120IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on whole body - including scalp. Chills. Pt treated with BENADRYL and topical hydrocortisone.

VAERS ID:560894 (history)  Vaccinated:2014-12-18
Age:48.0  Onset:2014-12-18, Days after vaccination: 0
Gender:Female  Submitted:2015-01-08, Days after onset: 21
Location:California  Entered:2015-01-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin/Iodine/Aspirin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ752770IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Rec''d PREVNAR 12-18-14. 12-19-14 came to appt. Mild swelling, tenderness, mild redness.

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